TECHNOLOGIES FOR THE ELDERLY: STATE OF THE ART AND NEW CHALLENGES

William C. Mann, OTR, PhDUniversity of Florida &Veterans Health Administration

Presentation Topics

Overview of technology for monitoring PERS Sensored Environments Wandering Alerts Residential Facility Monitoring Systems Medication Management Additional Technology Based Systems The Past / The Future

Some classes of available systems

• Personal Emergency Response Systems (PERS)

• Fall detecting systems• Mobile PERS• Residential facility monitoring systems• Home monitoring systems• Medication management systems• Home services platforms – social and

entertainment

FROM SMOKE SIGNALS TO ALERTS FROM SENSORED ENVIRONMENTS

•Lanterns and smoke signals•Phone•PERS•Passive monitoring / Sensored environments

PERS

Personal Emergency Response Systems

Personal Emergency Response Systems (PERS) Enable an individual to call for help in an

emergency Traditional PERS device (pendant,

wristwatch, clip-on) contact emergency numbers stored in the PERS console at the press of a button

User must manually activate the system within approximately 150 feet of the console unit

PERS

Traditional PERS

Philips Lifeline: http://www.lifelinesys.com/content/lifeline-products

PERS

Guardian Alert/Freedom Alert: 2-way voice pendant -http://www.logicmark.com/

• 2-way communication between the user and the console• Pendant contains a Digital Enhanced Cordless

Telecommunication (DECT) speakerphone• Wearer can talk to emergency contact up to 600 feet/183

meters from the console unit

PERS with Fall Detecting

Lifeline with AutoAlert: http://www.lifelinesys.com/content/

lifeline-products/auto-alert

Halo Monitoring:http://www.halomonitoring.com/

Wellcore: www.wellcore.com

mPERS (Mobil PERS)

• GPS and 3G wireless based mobile devices• Provide 2-way speakerphone communication,

location/tracking capabilities including geofencing to assist with the management of wandering

• Typically linked to a monthly monitoring/service contract which may provide access to web-based tools to monitor activity

• Provide one button access to monitoring company, caregivers or emergency services

• Some devices incorporate automatic fall detection, waterproof enclosures

Examples of mPERS

GeoSkeeper: Aerotel Medical Systems http://www.aerotel.com/en/products-solutions/lifecare-personal-safety-solutions/index.php

Lifecomm: http://www.lifecomm.com/devices.html

• Joint venture between Hughes Telematics, Qualcomm and AMAC

• Waterproof, compact and stylish design• Automatic fall detection and activity

monitoring

Examples of mPERS

Personal Assistant Link (PAL): ActiveCare http://www.activecare.com/pal

MobileHelp: http://www.mobilehelpnow.com/

VoCare: http://www.vocare.com/en/products/button

SENSORED ENVIRONMENTS

Research examples: Tiger Place

• Similar to Acube concept • Passive sensor networks have been installed in 17 apartments • Active retirement community developed in affiliation with the University of Missouri System block diagram from Rantz et al 2010

Research Examples: Tampa VA Smart Home “Cognitive Prosthetic” that enhances rehab and

improves safety for people with cognitive impairment Interactive location-based memory aids Ultra-wide band, read-time locating system 70 elders monitored for 1 year (completed) Up to 10 Veterans use system at one time following

acute care System uses UWB system from Ubisense LTD; able to

determine position of wrist-worn tag within .2 meters 60 wall mounted LCD touch screen computers with

applications providing schedule reminders, location assistance, and interactive prompts

Research examples: ACube

ACube (presented today) http://acube.fbk.eu/itFondazione Bruno Kessler, Università degli Studi di

Trento, Fondazione Don Carlo Gnocchi Onlus, Center for Research and Telecommunication Experimentation for Networked communities (CREATE-NET)

Sensors include: microphones, video cameras, RFID, WSN, wearable sensors, smart home sensors

WANDERING ALERTS

Wandering alerts: EmFinders GPS • Available in standard band and secure band (requires 2

hands to remove)• Water resistant and submergible• Requires 2 hour charge once a week• When active by a caregiver call to the service, the device

places a call to 911, reports its location, plays an audio message explaining the nature of the emergency, and an emergency response is provided by the appropriate responder organization.

• http://www.emfinders.com

RESIDENTIAL FACILITY MONITORING SYSTEMS

Residential facility monitoring systems

• Inobtrusively monitor resident activity to determine changes from normal behavior patterns

• Include sensors to monitor resident status and activity, such as– Motion sensors– Location tracking tags– Contact/door sensors– Toilet sensor– Stove sensor– Bed/chair sensors– Call pendants, pull cords– Vital sign monitoring

Residential facility monitoring systems

• Caregiver web portals – Configure individualized monitors for residents– Receive and manage system notifications– Reports of resident status– Some allow access to resident data by physicians and

family members

Examples: Inovonics Hardware

• Provides fixed and pendant transmitters, motion detectors for senior facilities

• Based on a proprietary 900MHz mesh network• Can provide location of the triggered pendant• Inovonics http://www.inovonics.com/activitysensor.aspx• Inovonics hardware is used in systems such as CareConnect from Esco

Technologies: http://www.careconnectbyesco.com It includes:• wireless emergency call system• Notifications• Reminders• environmental monitoring

/

Examples: Home Free Wireless Resident Monitoring Solutions

Products include:• Resident emergency call

– Fixed and resident-worn wireless call buttons– Alerts are directed to staff member pagers displaying resident name and real time

location

• Wandering solution – Personal WatcherTM

– Real-time indication of residents’ location by areas– Automatic alerts upon residents leaving or entering pre-defined areas– Door and exit alerts with staff notification– Watch-style transmitter with removal and cut-band alarms

• Wireless fall management of monitored seating or bed areas• Wireless staff safety• Community management and staff can generate resident behavioral and staff

responsiveness reports• :http://homefreesys.com

Examples: GE QuietCare

Living Independently Inc, acquired by GE, was a pioneer in the remote monitoring field

http://www.gehealthcare.com/usen/telehealth/quietcare/proactive_eldercare_technology.html

Examples: HealthSense An integrated solution including passive remote monitoring,

wireless emergency call/PERS with location tracking, nurse call system

http://www.healthsense.com/

Other Examples: WellAWARE Systems

Based on system developed by the University of Virginia: Includes: Sleep quality sensor Activity sensors in bedroom, bathroom, general living areas Threshold sensor to monitor entrance/egress Optional PERS console

LivingWell@Home Project : Good Samaritan Society collaborates with WellAWARE Systems, Philips Lifeline and Honeywell HomMed to study improvements to senior wellness: http://www.wellawaresystems.com/news/110322_press.php

• Philips Lifeline provides the medical alert service and fall detection components, including Lifeline with AutoAlert.

• Honeywell HomMed provides telehealth services for the LivingWell@Home research study. http://www.wellawaresystems.com

Home monitoring systems• Provide similar features as residential facility monitoring systems, aimed at in-home use • May also incorporate X-10, Zigby, Zwave, etc include “Smart home” features such as

– Temperature sensing– Control of home lighting

• Other features may include• Social connections to family

– Video conferencing– Simplified email interfaces– Share and view photos

• Entertainment– Simplified web interfaces– Games

• Wellness monitoring– Blood pressure– weight

• Caregiver alerts can be sent via phone, text messages, email based on changes in activity• Caregivers can monitor activity and status via a web based interface• Some systems utilize a wireless 3G connection to transmit data to the monitoring service,

provide VOIP phone service, in some cases eliminating the need for a home phone

Examples: GrandCare Systems• 2-way web video conferencing

• Interactive touchscreen interface

• Manage chronic health conditions

• Remotely assess activities of daily living

• Entertainment

• Temperature monitoring and lighting control

• http://www.grandcare.com/ (also available for residential facilities)

Other Examples

• AFrame Digital: http://www.aframedigital.com/index.htmlFeatures alerts if the wristwatch device is not being worn

• Simply Home: http://www.simply-home.com/

• CloseBy Network: http://www.closebynetwork.com/

Multi-service devicesSonamba Wellbeing Status monitor and Medical

Alert system: http://sonamba.com/

Wellbeing monitor PERS Medication reminders Social communications Digital photo frame Games Remote configuration

MEDICATION MANAGEMENT

Medication managementElectronic pill bottle

Vitality GlowCaps http://rxvitality.com/GlowCaps use light and sound to signal when it is time to take a pill. sense when the bottle is opened and wirelessly relay

their status to Vitality’s secure network. flash and play a ring-tone reminder wireless reminder light plugs into a kitchen or bathroom outlet

and pulses orange when it is time to take a pill. If the bottle is not opened two hours after a scheduled dose, the

user is automatically reminded with a telephone call or a text message

Data generated by GlowCaps can be used to automatically refill prescriptions

Medication ManagementElectronic pill boxes

Medminder Maya https://www.medminder.com/Medication-Management-System

Wireless link updates central systemwith the patient’s dosage activity

Provides patient reminders via thedevice and phone calls, text messagesand emails

Provides family and caregiver updates and web based reports

Medication ManagementAutomatic Dispensing Systems Store and releases medication on a set schedule Prevent overmedicating by accommodating "As Needed" medications

("PRNs") Provide patient reminders Alert caregiver or call center if the patient fails to take medicationTabSafe http://www.tabsafe.com/ Dispense A Pill (DAP)

http://www.healthonemed.com

Beyond physical health……

Therapeutic audio software CoroHealth: http://www.corohealth.com/

• Individualized programs• Includes music, faith-based

programming, news• Provides reminders to assist with daily

tasks• Scheduled content is played at

convenient times throughout the day• Residential facility (tablet or secure unit)

and home user (PC-based) versions

Residential facility (table, secure) and home users versions shown

ADDITIONAL TECHNOLOGY SYSTEMS

Computers and InteractionsTelikin simplified computer: http://www.telikin.com/• Touchscreen interface• Video chat• Photo sharing• Email• Calendar • Web browsing

Vitallink: http://www.vitallink.netSoftware shell for a touchscreen computerSimple access to • Photos• Videos• Video chat• News, weather, gamesEntertainment• Computer/web access

Connected Living: http://www.connectedliving.comProvides simplified access to the web, photos, email, calendar and games

AgeLab

Smart Personal Food Advisor• AgeLab has developed a Smart Personal Advisor to

provide guidance at the point of decision--in the aisle rather than in the home, uses personal diet information.

• Fosters “Technology-enabled behavior”• Leverages radio frequency identification (RFID) and

wireless technology • Can be used in the home, workplace, store and leisure

environments (Image from BusinessWeek

http://images.businessweek.com/ss/06/12/1205_boomertech/source/2.htm )

Challenges: development and adoption of technologies for the elderly

• Knowledge/skill /comfort with computers and electronics

• Sensory limitations– Sight– Hearing– Touch

• Motor limitations

• System reliability

• Security

• Rising cost of long term care

• Perception of benefits/advantages –feeling of need/want

• Adherence to adoption of mobile/wearable devices

• Ease of use/accessibility• Appropriate use of technology to

improve life• Reimbursement/cost• Privacy and trust – monitoring ranges

from the bedroom to the bathroom• Aging population and increasing

disability with age• Understanding the needs and

expectations of the aging population, including Aging in Place desires

• Training for caregivers, both formal and family

THE PAST /THE FUTUREAdvancement of Technology

Time

PowerOf Technology

2006

ROBOTICS……

Momoko – Experimental Theater

My Spoon

Toyota Robots

Farmer Wu’s home made robot

Rollin Justin (preparing tea)

Paro – robotic baby seals

I’m back….. (robotic arm)